Workaround motivation model (WAMM): an adaptation of the Theory of Interpersonal Behaviour

The study of workarounds (WA) has increased in importance due to their impact on patient safety and efficiency. However, there are no adequate theories to explain the motivation to create and use a workaround in a healthcare sitting. Although theories of technology acceptance help to understand the reasons to accept or reject technology, they fail to explain drivers for alternatives. Also workarounds involve creators and performers that have different motivations. Models such as Theory of Planned Behaviour (TPB) or Theory of Reasoned Action (TRA) can help to explain the role of workaround users, but lack explanation of workaround creators’ dynamics. Our aim is to develop a theoretical foundation to explain workaround motivation behaviour models with norms that relate to sanctions to provide an integrated Workaround Motivation Model; WAMM. The development of WAMM model is explained in this paper based on workaround cases as part of further research to establish the model.

Towards cost-sensitive adaptation: when is it worth updating your predictive model?

Our digital universe is rapidly expanding,more and more daily activities are digitally recorded, data arrives in streams, it needs to be analyzed in real time and may evolve over time. In the last decade many adaptive learning algorithms and prediction systems, which can automatically update themselves with the new incoming data, have been developed. The majority of those algorithms focus on improving the predictive performance and assume that model update is always desired as soon as possible and as frequently as possible. In this study we consider potential model update as an investment decision, which, as in the financial markets, should be taken only if a certain return on investment is expected. We introduce and motivate a new research problem for data streams ? cost-sensitive adaptation. We propose a reference framework for analyzing adaptation strategies in terms of costs and benefits. Our framework allows to characterize and decompose the costs of model updates, and to asses and interpret the gains in performance due to model adaptation for a given learning algorithm on a given prediction task. Our proof-of-concept experiment demonstrates how the framework can aid in analyzing and managing adaptation decisions in the chemical industry.

Non-replication of the association between 5HTTLPR and response to psychological therapy for child anxiety disorders

Background We previously reported an association between 5HTTLPR genotype and outcome following cognitive–behavioural therapy (CBT) in child anxiety (Cohort 1). Children homozygous for the low-expression short-allele showed more positive outcomes. Other similar studies have produced mixed results, with most reporting no association between genotype and CBT outcome. Aims To replicate the association between 5HTTLPR and CBT outcome in child anxiety from the Genes for Treatment study (GxT Cohort 2, n = 829). Method Logistic and linear mixed effects models were used to examine the relationship between 5HTTLPR and CBT outcomes. Mega-analyses using both cohorts were performed. Results There was no significant effect of 5HTTLPR on CBT outcomes in Cohort 2. Mega-analyses identified a significant association between 5HTTLPR and remission from all anxiety disorders at follow-up (odds ratio 0.45, P = 0.014), but not primary anxiety disorder outcomes. Conclusions The association between 5HTTLPR genotype and CBT outcome did not replicate. Short-allele homozygotes showed more positive treatment outcomes, but with small, non-significant effects. Future studies would benefit from utilising whole genome approaches and large, homogenous samples.

Radically open-dialectical behavior therapy for adult anorexia nervosa: feasibility and outcomes from an inpatient program

Background Anorexia Nervosa (AN) is a highly life-threatening disorder that is extremely difficult to treat. There is evidence that family-based therapies are effective for adolescent AN, but no treatment has been proven to be clearly effective for adult AN. The methodological challenges associated with studying the disorder have resulted in recommendations that new treatments undergo preliminary testing prior to being evaluated in a randomized clinical trial. The aim of this study was to provide preliminary evidence on the effectiveness of a treatment program based on a novel adaptation of Dialectical Behavior Therapy (DBT) for adult Anorexia Nervosa (Radically Open-DBT; RO-DBT) that conceptualizes AN as a disorder of overcontrol. Methods Forty-seven individuals diagnosed with Anorexia Nervosa-restrictive type (AN-R; mean admission body mass index = 14.43) received the adapted DBT inpatient program (mean length of treatment = 21.7 weeks). Results Seventy-two percent completed the treatment program demonstrating substantial increases in body mass index (BMI; mean change in BMI = 3.57) corresponding to a large effect size (d = 1.91). Thirty-five percent of treatment completers were in full remission, and an additional 55% were in partial remission resulting in an overall response rate of 90%. These same individuals demonstrated significant and large improvements in eating-disorder related psychopathology symptoms (d = 1.17), eating disorder-related quality of life (d = 1.03), and reductions in psychological distress (d = 1.34). Conclusions RO-DBT was associated with significant improvements in weight gain, reductions in eating disorder symptoms, decreases in eating-disorder related psychopathology and increases in eating disorder-related quality of life in a severely underweight sample. These findings provide preliminary support for RO-DBT in treating AN-R suggesting the importance of further evaluation examining long-term outcomes using randomized controlled trial methodology.

Researching farmer behaviour in climate change adaptation and sustainable agriculture: lessons learned from five case studies

Understanding farmer behaviour is needed for local agricultural systems to produce food sustainably while facing multiple pressures. We synthesize existing literature to identify three fundamental questions that correspond to three distinct areas of knowledge necessary to understand farmer behaviour: 1) decision-making model; 2) cross-scale and cross-level pressures; and 3) temporal dynamics. We use this framework to compare five interdisciplinary case studies of agricultural systems in distinct geographical contexts across the globe. We find that these three areas of knowledge are important to understanding farmer behaviour, and can be used to guide the interdisciplinary design and interpretation of studies in the future. Most importantly, we find that these three areas need to be addressed simultaneously in order to understand farmer behaviour. We also identify three methodological challenges hindering this understanding: the suitability of theoretical frameworks, the trade-offs among methods and the limited timeframe of typical research projects. We propose that a triangulation research strategy that makes use of mixed methods, or collaborations between researchers across mixed disciplines, can be used to successfully address all three areas simultaneously and show how this has been achieved in the case studies. The framework facilitates interdisciplinary research on farmer behaviour by opening up spaces of structured dialogue on assumptions, research questions and methods employed in investigation.

Training and the commitment of outsourced information technologies' workers: psychological contract fulfillment as a mediator

Outsourced workers in information technologies (IT) generally have high skills and a high value on the job market. Their IT outsourcing organizations are likely to provide them with training, in the first place for skill development, but perhaps also as a way to bind the workers to them. This can be understood along the role of the psychological contract. Outsourced IT workers may see training as a fulfillment of their psychological contract. Accordingly, we hypothesize that psychological contract fulfillment mediates the relationship between training and affective commitment to the IT outsourcer. This was tested in a sample of 158 Portuguese outsourced IT workers. The results showed that employees who considered that they were receiving good training opportunities felt a greater affective commitment to their IT outsourcers. This relationship was mediated by the fulfillment of the relational psychological contract.

Contingencies of contingent employment: psychological contract, job insecurity and employability of contracted workers

Drawing on psychological contract literature, the present study examines the emerging contingent employment relationships, which involve the contracted workers, the employment agency and the client organization on whose premises these employees work. This sample includes eighty-eight white-collar employees working for four Portuguese agencies. The results suggest that the perceived fulfilment of client?s obligations relates positively to the perceived fulfilment of agency?s obligations and that these constructs are independent of one another. Furthermore, as expected, we have found that the perception of job insecurity relates negatively to the fulfilment of agency?s obligations. No relationship was found between employability and the perceived fulfilment of client?s obligations. The results have implications for practitioners and future research.

Improving mood with psychoanalytic and cognitive therapies (IMPACT): a pragmatic effectiveness superiority trial to investigate whether specialised psychological treatment reduces the risk for relapse in adolescents with moderate to severe unipolar depression: study protocol for a randomised controlled trial

Background Up to 70% of adolescents with moderate to severe unipolar major depression respond to psychological treatment plus Fluoxetine (20-50 mg) with symptom reduction and improved social function reported by 24 weeks after beginning treatment. Around 20% of non responders appear treatment resistant and 30% of responders relapse within 2 years. The specific efficacy of different psychological therapies and the moderators and mediators that influence risk for relapse are unclear. The cost-effectiveness and safety of psychological treatments remain poorly evaluated. Methods/Design Improving Mood with Psychoanalytic and Cognitive Therapies, the IMPACT Study, will determine whether Cognitive Behavioural Therapy or Short Term Psychoanalytic Therapy is superior in reducing relapse compared with Specialist Clinical Care. The study is a multicentre pragmatic effectiveness superiority randomised clinical trial: Cognitive Behavioural Therapy consists of 20 sessions over 30 weeks, Short Term Psychoanalytic Psychotherapy 30 sessions over 30 weeks and Specialist Clinical Care 12 sessions over 20 weeks. We will recruit 540 patients with 180 randomised to each arm. Patients will be reassessed at 6, 12, 36, 52 and 86 weeks. Methodological aspects of the study are systematic recruitment, explicit inclusion criteria, reliability checks of assessments with control for rater shift, research assessors independent of treatment team and blind to randomization, analysis by intention to treat, data management using remote data entry, measures of quality assurance, advanced statistical analysis, manualised treatment protocols, checks of adherence and competence of therapists and assessment of cost-effectiveness. We will also determine whether time to recovery and/or relapse are moderated by variations in brain structure and function and selected genetic and hormone biomarkers taken at entry. Discussion The objective of this clinical trial is to determine whether there are specific effects of specialist psychotherapy that reduce relapse in unipolar major depression in adolescents and thereby costs of treatment to society. We also anticipate being able to utilise psychotherapy experience, neuroimaging, genetic and hormone measures to reveal what techniques and their protocols may work best for which patients.

Unpacking the mechanism by which psychological ownership manifests at the level of the individual: a dynamic model of identity and self

Increasing prominence of the psychological ownership (PO) construct in management studies raises questions about how PO manifests at the level of the individual. In this article, we unpack the mechanism by which individuals use PO to express aspects of their identity and explore how PO manifestations can display congruence as well as incongruence between layers of self. As a conceptual foundation, we develop a dynamic model of individual identity that differentiates between four layers of self, namely, the “core self,” “learned self,” “lived self,” and “perceived self.” We then bring identity and PO literatures together to suggest a framework of PO manifestation and expression viewed through the lens of the four presented layers of self. In exploring our framework, we develop a number of propositions that lay the foundation for future empirical and conceptual work and discuss implications for theory and practice.